An intensive care unit(ICU) is an important portion in the hospital where the highest level of continuous patient care and treatment is provided.ICU also called as intensive treatment unit(ITU) differs from other ordinary wards in that only serious ill patients are entered whose health condition is constantly monitored.Also the treatment is given on an hour by hour basis.

Approximately 3%-6% of the total hospital beds are allocated for ICU purpose in a modern hospital.The optimal size is six to eight beds organized in an ICU.Each bed area is supplied with oxygen,piped suction for clearing airways,medical compressed air and sometimes nitrous oxide.

Patients in an ICU often need mechanical ventilation in that a machine or ventilator assists or takes over with breathing.Moreover,each bed area shouldbe equipped with a self inflating resuscitation bag in case the mechanical ventilator fails for the staff to maintain artificial ventilation.

ICUs are of different types based on patients specific problem,medical staff,and equipment.Like burn wound intensive care unit(BWICU),respiratory intensive care unit(RICU),surgery intesive care unit(SICU) etc.The units serving primarily a single speciality (e.g cardiac surgery or neurosurgery units) are usually staffed by the speciality involved.Most general ICUs are staffed by the anesthetic department providing round the clock emergency services.

Here is a a snapshot of common equipment used in a unit and the care provided:

• Cadiac monitor......BP,heart rate & rhythm are monitored regularly & displayed on a monitor.
• Mechanical Ventilator...assists breathing through an endotracheal tube
• Pulse oximeter....to measure blood oxygen level
• Fluids are gven intravenously
• Suction equipment....to clear airways
• Feeding tubes.....Nutrients are supplied to the stomach through a tube,if required
• Drug therapy
• Trained medical and nursing staff

Patients admitted to the ICU are those whose lives are in imminent danger but in whom,its believed, that the immediate risk maybe averted by active and invasive treatment methods.Many conditions may lead to such a state but all of them involve failure or the threat of failure of the respiratory system and/or circulatory system.In addition,dysfunction of one or more of the renal,gastrointestinal,hepatic,hematological and neurological systems maybe present but involvement of one of these systems alone is rarely a reaon for the admission to the intensive treatment unit.

Two standard methods are used to judge if the patient needs intensive care.One is to divide the case condition into 4 grades.

Grade1-patients needn't regular monitoring

Grade2-patients need monitoring in case of accident(i.e patient condition is unsteady)
Grade3-patients need invasive monitoring(the accident may take place at any time)
Grade4-patients condition is so severe that patient must proceed compicated monitoring.Special treatment measures are taken.

Grade3 and grade4 mustbe admitted to the ICU.The other method is threpauetic intervention scoring system(TISS).Patients whose score is more than four are admitted to the ICU.

An ICU is inappropriate place for patients whose death is judged inevitable because of their acute illness or underlying disease.Forexample the severe chronic bronchitis on maximum treatment or the terminal cancer patient.It becomes a moral responsibility of ICU staff to inform patients relatives if its clear that patient can not lead an independant existence.On this time relatives shouldn't insist on patients admission and cooperate the medical staff.